Patti Silva: Alright. Good evening everyone.
Jacovino, Shannon: Yeah.
Patti Silva: I'm Patty Silva, chair of the council, and welcome everybody.
Patti Silva: Calling this meeting to order it is 5:04 PM and it's October
Patti Silva: 17th, 2024.
Patti Silva: 1st Order of Business is opportunity for public
Patti Silva: participation.
Patti Silva: Is there anybody from the public who would like to say a few
Patti Silva: words?
Patti Silva: K There being none, we'll move on.
Patti Silva: Our first item of for topics for discussion.
Patti Silva: Just a reminder that the September meeting.
Patti Silva: Draft transcript video are all available on the DDS website
Patti Silva: under the DDS Council portion and that there is a live link on
Patti Silva: our agendas to get there.
Patti Silva: So just a little easy easy way to move on over there if you
Patti Silva: want to check things out.
Patti Silva: And that's where they'll always be every month.
Patti Silva: So just trying to give everybody a reminder, because things are
Patti Silva: still a little bit new.
Patti Silva: So next on our agenda, we have Joshua Skolara here.
Patti Silva: To do a presentation on the Pulse night demo, which we are
Patti Silva: all very interested in hearing about. Josh, why don't you go
Patti Silva: ahead and introduce yourself and I believe you have some other
Patti Silva: staff here with you as well. We'd love to get to know who
Patti Silva: they are and.
Patti Silva: Very interested in hearing what you have to say.
Patti Silva: Thank you.
Scalora, Joshua D: Thank you.
Scalora, Joshua D: That's wonderful.
Scalora, Joshua D: Thank you for inviting me.
Scalora, Joshua D: Thank you to to everyone here and Commissioner Schaeff, and
Scalora, Joshua D: thanks to Maliki. Malika, thank you and Murali Pillai for
Scalora, Joshua D: joining from the Pulse light team. And they are with the
Scalora, Joshua D: company that developed the pulse light aura application.
Scalora, Joshua D: So that's great.
Scalora, Joshua D: You have one of the local subject matter experts here.
Scalora, Joshua D: That's me.
Scalora, Joshua D: My team uses the pulse light.
Scalora, Joshua D: Location. And I'm gonna gonna talk to you about that today,
Scalora, Joshua D: but we also have experts from the team that developed the
Scalora, Joshua D: application.
Scalora, Joshua D: So Malika, would you like to introduce yourself?
Mallika Thanky: Oh, yes. Hi, thank you.
Mallika Thanky: My name's malika.
Mallika Thanky: Thank you.
Mallika Thanky: I'm with Pulsight and I work a lot on the product side of
Mallika Thanky: things, so I'm excited to kind of hear what you guys think
Mallika Thanky: about this, but really I'm more here to just see how these DD
Mallika Thanky: Council meetings go and kind of hear what people are saying and.
Mallika Thanky: What are the issues going on?
Mallika Thanky: So thank you for having me.
Mallika Thanky: I appreciate it.
Scalora, Joshua D: Thank you. And also Murali, would you like to say hello?
Murali Pillai: Sure. Good afternoon everybody.
Murali Pillai: I'm Raleigh lay news member of Paul's life, but been working
Murali Pillai: with home community based services and LTSS programs
Murali Pillai: probably since about 2004 in a variety of capacities across the
Murali Pillai: country.
Murali Pillai: So happy to participate and listen in and eager to learn
Murali Pillai: more about what the Council's focused on here in Connecticut.
Murali Pillai: Thank you.
Scalora, Joshua D: Thank you. Before I start, would Commissioner Schaeff like to say
Scalora, Joshua D: anything?
Scalora, Joshua D: He's been a pivotal part in the creation of the what you're
Scalora, Joshua D: about to see.
Scalora, Joshua D: So he he may have something just to cue me up here.
Scheff, Jordan A: So since we have some relatively newer members to the Council who
Scheff, Jordan A: haven't heard my story on this, I'm going to try and do it in
Scheff, Jordan A: under a minute.
Scheff, Jordan A: So a number of years ago we faced inspection from the office
Scheff, Jordan A: Inspector General following Hartford current centerfold
Scheff, Jordan A: article on undetected abuse and neglect or unreported abuse and
Scheff, Jordan A: neglect.
Scheff, Jordan A: And it started a cascade of events and after several years
Scheff, Jordan A: of OIG audit, we were in the.
Scheff, Jordan A: Needing to figure out a way that we could.
Scheff, Jordan A: Track unreported incidents and and try and learn to identify
Scheff, Jordan A: them and what we were able to do is pulse light was already
Scheff, Jordan A: engaged on a waste, fraud and abuse prevention at DSS.
Scheff, Jordan A: More on the financial side of things and we were looking to
Scheff, Jordan A: take their work.
Scheff, Jordan A: And shape it for for our needs.
Scheff, Jordan A: And I went to a demo where they had used a whole bunch of
Scheff, Jordan A: Medicaid data points.
Scheff, Jordan A: To help run what now looks a like a rudimentary slide and and
Scheff, Jordan A: and provide some information.
Scheff, Jordan A: And it was pretty startling.
Scheff, Jordan A: Because what I realized was that I lost a lot of sleep over
Scheff, Jordan A: knowing that there were things I didn't know.
Scheff, Jordan A: And then I saw the presentation from them and I realized some of
Scheff, Jordan A: the things that kept me up at night I could know about if I
Scheff, Jordan A: had a way to use that data to inform me, to inform the
Scheff, Jordan A: department to inform.
Scheff, Jordan A: Providers.
Scheff, Jordan A: About issues and it has since grown far beyond the scope of
Scheff, Jordan A: the original ASK, and our partnership with Pulse light has
Scheff, Jordan A: grown.
Scheff, Jordan A: And we have a very close partnership.
Scheff, Jordan A: But Josh and Malika and others spend a lot of time figuring out
Scheff, Jordan A: what what could we add? What could?
Scheff, Jordan A: What else do we need to know that we don't know?
Scheff, Jordan A: Along the route.
Scheff, Jordan A: Their their their founder and I had a conversation about how
Scheff, Jordan A: they might improve the work they do, and I mean not with us
Scheff, Jordan A: tonight. But I suggested that they come out and visit site
Scheff, Jordan A: locations and see what a day program looks like and see what
Scheff, Jordan A: a residential program.
Scheff, Jordan A: Looks like.
Scheff, Jordan A: See what an institutional setting looks like so they could
Scheff, Jordan A: ground some of their data science and and and it work in
Scheff, Jordan A: the very nature of the work that we do.
Scheff, Jordan A: And I think that they found that really beneficial.
Scheff, Jordan A: They can now see the impact.
Scheff, Jordan A: They can see the people, they can relate diagnostic codes to
Scheff, Jordan A: people's lives and why this work has become so important, and I'm
Scheff, Jordan A: going to get off my pulse light bandwagon in a second and turn
Scheff, Jordan A: it back to you, Josh. I. It's also very interesting because
Scheff, Jordan A: it's a.
Scheff, Jordan A: Woman owned Woman founded Minority owned Company and
Scheff, Jordan A: Malika, I think you're also vice president in addition to your
Scheff, Jordan A: other hats or a title, something like that.
Mallika Thanky: Yes, Vice president of product strategy, I think.
Scheff, Jordan A: Yeah.
Scheff, Jordan A: Which is just terrific.
Scheff, Jordan A: So we've had a long term partnership and Irene and I like
Scheff, Jordan A: to leave Josh and Malika alone to conjure up new asks of the
Scheff, Jordan A: data and to have it tell more stories.
Scheff, Jordan A: And they do a phenomenal job and I'm hoping you'll get a glimpse
Scheff, Jordan A: into that in the presentation. They're going to do now.
Scheff, Jordan A: And thank you for the opportunity to tee that up,
Scheff, Jordan A: Josh.
Scalora, Joshua D: Thank you so much, Commissioner, chef and I would just like to
Scalora, Joshua D: say yes, the the pulse light team has walked with us. You
Scalora, Joshua D: know, we've spent.
Scalora, Joshua D: Probably hundreds of hours now.
Scalora, Joshua D: It's been several years and we did product development together
Scalora, Joshua D: really and then we've been using the tool and continue to meet
Scalora, Joshua D: with the the team on a pretty much a weekly basis.
Scalora, Joshua D: We continue to work on improving the product that I'm about to
Scalora, Joshua D: share with you and what I want you to know is that it's not.
Scalora, Joshua D: I'm done.
Scalora, Joshua D: So and a lot of the new capabilities we've that we've
Scalora, Joshua D: gotten through the use of what we'll refer to as aura, they're
Scalora, Joshua D: new for us as well.
Scalora, Joshua D: So we're learning new ways to use this information and without
Scalora, Joshua D: further ado, I'll start the presentation.
Scalora, Joshua D: I believe that I have about 15 minutes of presentation and that
Scalora, Joshua D: that I expect there might be some discussion afterwards and.
Scalora, Joshua D: I also like to say thank you for inviting me and this is my first
Scalora, Joshua D: discussion with you about this, but doesn't have to be the last.
Scalora, Joshua D: So there might be things like follow up info you would like or
Scalora, Joshua D: questions or further information we can dive into in another
Scalora, Joshua D: visit, all right.
Scalora, Joshua D: Thank you so much.
Scalora, Joshua D: With that, I'm going to start sharing my screen.
Scalora, Joshua D: I'll look for confirmation.
Scalora, Joshua D: Verbal confirmation that people can see my screen.
Scalora, Joshua D: Alright. And in visual I got both OK and now I'm going full
Bronson, Kevin: Yes.
Scalora, Joshua D: screen.
Scalora, Joshua D: Alright, excellent.
Scalora, Joshua D: So we're gonna talk about how powerful technology that pulsate
Scalora, Joshua D: developed helps Connecticut, DDS, enhance the quality of care
Scalora, Joshua D: for individuals.
Scalora, Joshua D: We'll talk a little bit about what the catalyst was. I think
Scalora, Joshua D: Commissioner Chef really summarized it perfectly.
Scalora, Joshua D: We'll revisit that a little bit.
Scalora, Joshua D: How we we kind of got started and what we call the automatic
Scalora, Joshua D: ingest and analysis of claims and that means that.
Scalora, Joshua D: There's a bunch of data that's getting sent to pulse light from
Scalora, Joshua D: different sources, and they're taking it in in their tool and
Scalora, Joshua D: analyzing it for us and then feeding it back to us as analyze
Scalora, Joshua D: data.
Scalora, Joshua D: We'll talk about how we're using it to help people today and then
Scalora, Joshua D: how else we could use it.
Scalora, Joshua D: What are some other things that we could do?
Scalora, Joshua D: I can't monitor anything other than looking at the full screen,
Scalora, Joshua D: so if anyone anything comes up in the chat or if there's a hand
Scalora, Joshua D: up or anything, if someone could help with that. Thank you so
Scalora, Joshua D: much.
Scheff, Jordan A: I will I.
Tsegai, Wesaneit: Goodbye, Josh.
Scheff, Jordan A: I will. I I I'm sorry, Wes.
Scheff, Jordan A: I'm stepping on your words, but I think Malika may want to hear
Scheff, Jordan A: this.
Scheff, Jordan A: Adriana Ramirez is one of our council members and the
Scheff, Jordan A: President of Connecticut Family Support Network as well.
Scheff, Jordan A: And she used the phrase humanize the data. And I think Irene May
Scheff, Jordan A: want to hear that at some point.
Scalora, Joshua D: Yes, I think so.
Scalora, Joshua D: I think it's been an amazing date journey for us with this
Scalora, Joshua D: technology provider. For them learning about our culture and
Scalora, Joshua D: the care that we have for individuals and how intentional
Scalora, Joshua D: we really needed to be to use data to to find these
Scalora, Joshua D: potentially unreported incidents and do something with.
Scalora, Joshua D: It so it's been a great journey with them as well.
Scalora, Joshua D: What got us here?
Scalora, Joshua D: What was the catalyst Commissioner Schaeff talked
Scalora, Joshua D: about the OIG on it.
Scalora, Joshua D: Here to talk about the intricacies of the settings
Scalora, Joshua D: rule, the joint report or the access rule.
Scalora, Joshua D: But they are influential on this discussion.
Scalora, Joshua D: The settings rule was a change in the quality framework for the
Scalora, Joshua D: Medicaid waiver system, and it introduced some specific new
Scalora, Joshua D: reporting requirements around critical incidents.
Scalora, Joshua D: There was 3 audits here, Connecticut, Mass and Maine, and
Scalora, Joshua D: then a joint report was issued with findings and
Scalora, Joshua D: recommendations.
Scalora, Joshua D: For using claims to find unreported incidents, that is
Scalora, Joshua D: the methodology that was utilized in the audit, the
Scalora, Joshua D: Office of Inspector General received.
Scalora, Joshua D: A list of individuals that lived in DDS supported locations for a
Scalora, Joshua D: time period, and then they went to Department of Social Services
Scalora, Joshua D: and from their Medicaid data warehouse got claims the full
Scalora, Joshua D: claim set for those individuals for those individuals with those
Scalora, Joshua D: Medicaid numbers.
Scalora, Joshua D: Medicaid IDs for that time period.
Scalora, Joshua D: And they they did a gap analysis.
Scalora, Joshua D: They found things that were an emergency room visit or a
Scalora, Joshua D: hospital visit or admission even that looked like it met our
Scalora, Joshua D: requirement for being reported to us. And then they asked us to
Scalora, Joshua D: produce the report that should have accompanied that and in
Scalora, Joshua D: some cases we weren't able to.
Scalora, Joshua D: And that's really where we started to realize.
Scalora, Joshua D: There's obviously so much more to the picture than what people
Scalora, Joshua D: tell us about.
Scalora, Joshua D: But if we only know what people tell us about, we'll never know
Scalora, Joshua D: the full picture.
Scalora, Joshua D: And we knew we needed to do more.
Scalora, Joshua D: There were several other audits, as you can see, that led to a
Scalora, Joshua D: lot more learning from the US Office of Inspector General, but
Scalora, Joshua D: also CMS. They're not the same organization. They're two
Scalora, Joshua D: different federal orgs.
Scalora, Joshua D: But they work.
Scalora, Joshua D: They work closely together and they're both interested in this
Scalora, Joshua D: issue.
Scalora, Joshua D: You and they've issued the joint report as a group of federal
Scalora, Joshua D: agencies and a lot of the findings and learning that the
Scalora, Joshua D: federal government has done in the interim has led to the
Scalora, Joshua D: access rule and the access rule is the next iteration of the
Scalora, Joshua D: waiver quality framework Rev.
Scalora, Joshua D: And it updates definitions of critical incidents across all
Scalora, Joshua D: waiver types, not only waivers for people with intellectual
Scalora, Joshua D: disabilities.
Scalora, Joshua D: But every single.
Scalora, Joshua D: Medicaid waiver type.
Scalora, Joshua D: It creates one national standard.
Scalora, Joshua D: It's a minimum standard that can be layered on and enhanced by
Scalora, Joshua D: states, and it's expected to be added to, but at a minimum the
Scalora, Joshua D: the new.
Scalora, Joshua D: The new standard in the future will be a critical incident is
Scalora, Joshua D: an incident where there is suspicion or reasonable
Scalora, Joshua D: suspicion of abuse, neglect or exploitation. So.
Scalora, Joshua D: We had these findings that led to us realizing that we needed
Scalora, Joshua D: to use Medicaid claims to find unreported incidents.
Scalora, Joshua D: And we tried to do it ourselves. It was really challenging.
Scalora, Joshua D: While we were working on that, we learned as Commissioner Chef
Scalora, Joshua D: mentioned, that our Department of Social Services in
Scalora, Joshua D: Connecticut had partnered with the company Pulse Light to
Scalora, Joshua D: develop software to help detect fraud, waste and abuse in the
Scalora, Joshua D: Medicaid claims. And functionally, what that meant is
Scalora, Joshua D: that pulse lay.
Scalora, Joshua D: An external company in a cloud based company was getting the
Scalora, Joshua D: full Medicaid claim set from Connecticut already.
Scalora, Joshua D: And.
Scalora, Joshua D: Our data was within the data that they already were getting,
Scalora, Joshua D: so that that posed a unique opportunity to leverage a
Scalora, Joshua D: solution that was built around a data set.
Scalora, Joshua D: And update the the rules etcetera. To instead find
Scalora, Joshua D: fraudulent billing now.
Scalora, Joshua D: Find potential unreported incidents.
Scalora, Joshua D: While we were doing that, we were trying very hard to use
Scalora, Joshua D: that same data to find these things.
Scalora, Joshua D: We just found too many.
Scalora, Joshua D: That was the problem. We didn't have a way to wade through all
Scalora, Joshua D: the data to organize and prioritize it.
Scalora, Joshua D: And there are so many lines of data that we were asked to print
Scalora, Joshua D: six months worth of data and bring it to a meeting.
Scalora, Joshua D: And we really question the value of turning the electronic, you
Scalora, Joshua D: know, Excel documents into into paper.
Scalora, Joshua D: But we were vehemently told do it and it was about 500 page.
Scalora, Joshua D: So I like to joke that I'm the director of Business
Scalora, Joshua D: Intelligence and that was like the opposite of that.
Scalora, Joshua D: It was almost impossible to use and when we did get a demo from
Scalora, Joshua D: Pulse light, the demonstration showed us some things really
Scalora, Joshua D: quickly.
Scalora, Joshua D: It showed us a pattern of injuries and although the data
Scalora, Joshua D: in the system, let's say the all of the details were changed
Scalora, Joshua D: other than the claim code types.
Scalora, Joshua D: The data was based on real data.
Scalora, Joshua D: And the data was recognizable to us.
Scalora, Joshua D: It was related to an accident, a vehicle accident, and it was
Scalora, Joshua D: incredibly impactful for us to see that this tool worked to
Scalora, Joshua D: show us something that we knew about and we could identify it.
Scalora, Joshua D: This tool could show us that vehicle accident with a cluster
Scalora, Joshua D: of injuries and se.
Scalora, Joshua D: Injuries this tool could help us see things that we.
Scalora, Joshua D: We would only know about if people told us about them, so it
Scalora, Joshua D: was really a powerful.
Scalora, Joshua D: Observation for us and we realized that the claims data
Scalora, Joshua D: could be mined to find unreported incidents and allow
Scalora, Joshua D: follow up and resolution.
Scalora, Joshua D: So we talked about Pulse Light Commissioner, Chef mentioned
Scalora, Joshua D: that Pulse Light's a woman owned business and the business is
Scalora, Joshua D: really organized around helping Health and Human service
Scalora, Joshua D: agencies improve health and safety and outcomes for
Scalora, Joshua D: individuals.
Scalora, Joshua D: And enhancing person centred care quality.
Scalora, Joshua D: HealthEquity incident and abuse, neglect and exploitation,
Scalora, Joshua D: detection, management and prevention and the aura tool
Scalora, Joshua D: that was developed after our initial incident reporting tool.
Scalora, Joshua D: Really puts a 360° view around the person and gives some
Scalora, Joshua D: amazing new capabilities to us that we'll talk about in a
Scalora, Joshua D: moment.
Scalora, Joshua D: But first of all, what types of claims are available for
Scalora, Joshua D: analysis?
Scalora, Joshua D: In Aura, we talk a lot about claims.
Scalora, Joshua D: And they're not all one thing, but basically, these are bills
Scalora, Joshua D: for services that were Medicaid, billable services, and these are
Scalora, Joshua D: Medicaid claims primarily.
Scalora, Joshua D: These are professional claims for services by medical
Scalora, Joshua D: professionals.
Scalora, Joshua D: Institutional claims, so things that like might be billed at a a
Scalora, Joshua D: sniff or something like that.
Scalora, Joshua D: A certified nursing facility pharmacy claims or things like
Scalora, Joshua D: durable medical equipment.
Scalora, Joshua D: Rental claims.
Scalora, Joshua D: That is a major indicator. Restorative dental can be a
Scalora, Joshua D: major indicator of.
Scalora, Joshua D: Abuse as can extractions be an indicator of neglect?
Scalora, Joshua D: Sometimes. So there's different uses for that dental claims, and
Scalora, Joshua D: they're different indicators for what that data may mean for the
Scalora, Joshua D: individuals who are experiencing it.
Scalora, Joshua D: And then there's also these services by federally qualified
Scalora, Joshua D: health centers.
Scalora, Joshua D: Those are the different types of claims.
Scalora, Joshua D: And when we look at and think about the data, first of all, I
Scalora, Joshua D: wanna give all credit to slides and I know it's on the screen,
Scalora, Joshua D: but pulse light develop this deck and they are better at it
Scalora, Joshua D: than me.
Scalora, Joshua D: So if there's fancy stuff that you see, they did it.
Scalora, Joshua D: Thank you for helping with that and it is a partnership really,
Scalora, Joshua D: but starting with Medicaid claims, we also bring in an
Scalora, Joshua D: agency data.
Scalora, Joshua D: So that would be data around the individuals who are.
Scalora, Joshua D: On the Medicaid waivers and receive waiver supports.
Scalora, Joshua D: Out of our data system, including placements of the
Scalora, Joshua D: services that individuals get, the providers that support them.
Scalora, Joshua D: There's a unique identifier in our data system called an rdid.
Scalora, Joshua D: It's a residential and day ID.
Scalora, Joshua D: It's alphanumeric and it has unique identifiers for things
Scalora, Joshua D: that like tells them if it's public or private. If it's
Scalora, Joshua D: reserved A and then those are also tied to location based
Scalora, Joshua D: services.
Scalora, Joshua D: So we can organize things.
Scalora, Joshua D: On that and in addition to that, we're pulling in incident
Scalora, Joshua D: reporting data, critical incident restraint, met error
Scalora, Joshua D: allegations of abuse, neglect and other data which we'll dive
Scalora, Joshua D: into.
Scalora, Joshua D: But there's a lot of other different types of data that can
Scalora, Joshua D: be joined with that, and we're not joining with all of those
Scalora, Joshua D: types of data. But I do want to call that out.
Scalora, Joshua D: Some examples might be needs assessment. Medicare, which is a
Scalora, Joshua D: high priority for Commissioner chef, and we're going to be
Scalora, Joshua D: working with our with DSS on gaining access to that
Scalora, Joshua D: information in the future.
Scalora, Joshua D: ADT admit discharge transfer, which we'll talk a little bit
Scalora, Joshua D: about.
Scalora, Joshua D: Medicaid Fraud control unit.
Scalora, Joshua D: These are a lot of acronyms.
Scalora, Joshua D: I'll keep going though, just reading them out.
Scalora, Joshua D: Adult Protective Services, Child Protective Services, substance
Scalora, Joshua D: abuse prevention.
Scalora, Joshua D: Grieving systems, electronic visit verification and wait list
Scalora, Joshua D: systems.
Scalora, Joshua D: Some states join their different elements of these systems in
Scalora, Joshua D: combination with.
Scalora, Joshua D: Aura to provide a more nuanced view of the information in the
Scalora, Joshua D: individual provider and service locations, and this information
Scalora, Joshua D: is useful not just.
Scalora, Joshua D: To 8 people that are supporting individuals with intellectual
Scalora, Joshua D: and developmental disabilities, but all long term services and
Scalora, Joshua D: supports.
Scalora, Joshua D: Mental health, aging, regulatory and money follows the person,
Scalora, Joshua D: and in general it can be either a single or multi agency
Scalora, Joshua D: program. For example, some states have one Health and Human
Scalora, Joshua D: service agency.
Scalora, Joshua D: That's not atypical.
Scalora, Joshua D: That's kind of the norm.
Scalora, Joshua D: And we're also the norm. I I don't know if it's 5050,
Scalora, Joshua D: Commissioner. Chef probably knows better, but.
Scalora, Joshua D: You know, in some states if they're using aura, they might
Scalora, Joshua D: be using it across and the Health and Human services
Scalora, Joshua D: sphere. In Connecticut, there's a couple of the agencies.
Scalora, Joshua D: These are using it now.
Scalora, Joshua D: There's some additional growth beyond DSS and and DDS and I
Scalora, Joshua D: know we have a vision to share the insights that we get from
Scalora, Joshua D: the aura system.
Scalora, Joshua D: With.
Scalora, Joshua D: Others so that they may benefit as well.
Scalora, Joshua D: So we started using Aura to conduct a monthly review where
Scalora, Joshua D: we.
Scalora, Joshua D: Basically, run reports that detect critical incidents for
Scalora, Joshua D: DDS individuals for a time period. We, like I said, we do
Scalora, Joshua D: it every month.
Scalora, Joshua D: We've been doing it for several years now and when we detect
Scalora, Joshua D: critical incidents, what that means is we get a report in the
Scalora, Joshua D: pulse light aura system.
Scalora, Joshua D: And it has data that is information about.
Scalora, Joshua D: Experiences that people had around medical treatments and
Scalora, Joshua D: we've worked with pulse light in their team to tailor the claims
Scalora, Joshua D: that are used to detect these things and show them to us.
Scalora, Joshua D: To our incident and critical incident procedure.
Scalora, Joshua D: So they're showing us things that our procedure says that we
Scalora, Joshua D: should be looking at that should be reported to us and things
Scalora, Joshua D: that are.
Scalora, Joshua D: Those are the detective critical incidents.
Scalora, Joshua D: We review those every month and there there's a a
Scalora, Joshua D: interdisciplinary team that reviews that information, does
Scalora, Joshua D: research to triage.
Scalora, Joshua D: To identify if if we knew about it, but it just wasn't entered
Scalora, Joshua D: into our data system.
Scalora, Joshua D: If for instance, is there a case note about it?
Scalora, Joshua D: Was the case manager informed?
Scalora, Joshua D: Was the health services director informed?
Scalora, Joshua D: Did the right people know about this thing, or was there an
Scalora, Joshua D: allegation of or and investigation of abuse or
Scalora, Joshua D: neglect?
Scalora, Joshua D: So we're already sending that information, but we also do an
Scalora, Joshua D: additional check to say, did we miss anything in the in, in the
Scalora, Joshua D: algorithm? Were there things that were outside the date range
Scalora, Joshua D: that look like they might line up?
Scalora, Joshua D: So we do an additional review to see if we can find any more
Scalora, Joshua D: information. And then there's a follow up process to ensure
Scalora, Joshua D: proper reporting.
Scalora, Joshua D: Solution and the follow up can occur specifically for critical
Scalora, Joshua D: incidents.
Scalora, Joshua D: There's a number of things per procedure that are supposed to
Scalora, Joshua D: happen.
Scalora, Joshua D: The reason?
Scalora, Joshua D: The procedure requires those things to happen is that they
Scalora, Joshua D: make sure that the team is aware of what occurred and that
Scalora, Joshua D: there's occurred that they're able to do preventative measures
Scalora, Joshua D: if necessary.
Scalora, Joshua D: But after we started using it, it's very effective.
Scalora, Joshua D: We're able to do follow up with providers and ensure that the
Scalora, Joshua D: team is informed and that all the right people are are know
Scalora, Joshua D: about something that happened.
Scalora, Joshua D: We're seeing better reporting in the in, in our system, a better
Scalora, Joshua D: knowledge of the reporting requirements because we're
Scalora, Joshua D: shedding more light on the system as a whole. But in
Scalora, Joshua D: general, there was some information lacking and a couple
Scalora, Joshua D: of the things that we were missing that we really wanted.
Scalora, Joshua D: To.
Scalora, Joshua D: Add to the system was level of need the people at DDS that use
Scalora, Joshua D: the tool to review these incidents often are going back
Scalora, Joshua D: and forth between the level of need application and the pulse
Scalora, Joshua D: light application to verify what the person's level of
Scalora, Joshua D: supervision was or if they.
Scalora, Joshua D: Had a choking event. Do they have disposers?
Scalora, Joshua D: There are some other thing like another part of their diagnosis
Scalora, Joshua D: or a risk factor from their level. The individual's level of
Scalora, Joshua D: need assessment that would explain what.
Scalora, Joshua D: Heard or be relevant to the situation?
Scalora, Joshua D: Specifically for supervision, that is something that is looked
Scalora, Joshua D: at very, very closely whenever there's an adverse event in,
Scalora, Joshua D: specifically in provider operated locations, we're
Scalora, Joshua D: looking to see, did the person have enhanced supervision.
Scalora, Joshua D: Did they have some sort of protocol or plan in place to
Scalora, Joshua D: prevent whatever did occur from occurring?
Scalora, Joshua D: And then maybe a system broke down.
Scalora, Joshua D: So we're really trying to do preventative measures as well.
Scalora, Joshua D: And we also wanted to to gain information faster.
Scalora, Joshua D: So it was a long time goal of Commissioner chefs to add,
Scalora, Joshua D: admit, discharge and transfer information.
Scalora, Joshua D: I don't know if anyone's heard of that before, but that is
Scalora, Joshua D: information that health providers like medical.
Scalora, Joshua D: Systems and hospitals send to the state health information
Scalora, Joshua D: exchange when someone is admitted discharge or
Scalora, Joshua D: transferred from a hospital.
Scalora, Joshua D: And then or an emergency room. And that is for all emergency
Scalora, Joshua D: rooms in the state of Connecticut.
Scalora, Joshua D: All are supposed to send that information to Connie.
Scalora, Joshua D: That's the state's health information exchange.
Scalora, Joshua D: And what we wanted to do was see if we could get an early warning
Scalora, Joshua D: system. The claims are amazing, but there's a time delay in
Scalora, Joshua D: claims.
Scalora, Joshua D: So the claim is based on that service being provided and then
Scalora, Joshua D: the bill being submitted.
Scalora, Joshua D: And we send data every two weeks to pulse light and DSS sends
Scalora, Joshua D: data every two weeks. But claims can be 30 or even 60 days in
Scalora, Joshua D: arrears. So you can see that that helps us find important to
Scalora, Joshua D: know information.
Scalora, Joshua D: But there's a little time delay, so how could we find out things
Scalora, Joshua D: faster?
Scalora, Joshua D: We wanted to add admit, discharge and transfer.
Scalora, Joshua D: That's the early warning system. The thing that tells us
Scalora, Joshua D: something bad happened right away.
Scalora, Joshua D: And by getting that information, we're hoping to be able.
Scalora, Joshua D: To create a system where we're reaching out more sooner and
Scalora, Joshua D: we're able to prevent less unmatched detected critical
Scalora, Joshua D: incidents down the road. For instance, a lot of the things
Scalora, Joshua D: that we find, you know two months later if we knew about it
Scalora, Joshua D: now we could ask for that Inc.
Scalora, Joshua D: Report this week and maybe get it next week and it wouldn't be
Scalora, Joshua D: late.
Scalora, Joshua D: The team would know about it in time, so we're really shifting
Scalora, Joshua D: our focus to see if we can.
Scalora, Joshua D: Learn about the admin discharge and use that admit discharge and
Scalora, Joshua D: transfer information.
Scalora, Joshua D: To do interventions more quickly and we, we also added emergency
Scalora, Joshua D: room analysis to the tool this year.
Scalora, Joshua D: So those tools have been incredibly impactful, but beyond
Scalora, Joshua D: the tools that DDS uses, pulse light created a new version of
Scalora, Joshua D: their application which we benefited from.
Scalora, Joshua D: This is beyond our original use and that's aura.
Scalora, Joshua D: This is something that DDS is very excited about, and I think
Scalora, Joshua D: others are as well.
Scalora, Joshua D: Because it's created a real expanded view of information.
Scalora, Joshua D: It helps us see provider performance, gives us a view
Scalora, Joshua D: into HealthEquity, gives us a lens into the fatal 5 plus
Scalora, Joshua D: conditions for individuals.
Scalora, Joshua D: Other adverse conditions like diabetes and heart disease, we
Scalora, Joshua D: can track care, drug utilization, service utilization
Scalora, Joshua D: and analysis.
Scalora, Joshua D: How am I doing on time, Commissioner? Is the pace OK?
Scheff, Jordan A: Yeah, we're at 5:30 now.
Scheff, Jordan A: How many more slides do you have?
Scalora, Joshua D: Just a few more slides.
Scheff, Jordan A: OK.
Scheff, Jordan A: Yeah, if you can get that, that that's great. 'cause, I I
Scalora, Joshua D: So.
Scheff, Jordan A: getting I know people will have questions, so.
Scalora, Joshua D: Yeah. And I think you're just gonna see more of what I've
Scalora, Joshua D: already talked about.
Scalora, Joshua D: So I I'll definitely summarize these slides pretty quickly.
Scalora, Joshua D: I wanted to to show that.
Scheff, Jordan A: Thanks.
Scalora, Joshua D: Thank you.
Scalora, Joshua D: I wanted to show that in the area of critical incidents we
Scalora, Joshua D: talked about how we're using the tool for these unreported
Scalora, Joshua D: incident detection and to ensure that there's resolution. We're
Scalora, Joshua D: also able to see risk factors.
Scalora, Joshua D: Use the tool as part of conducting an investigation.
Scalora, Joshua D: Or conduct the outreach to the provider to ensure proper
Scalora, Joshua D: reporting gives us new management and oversight tools
Scalora, Joshua D: as well new views into fiscal impact of our investment in
Scalora, Joshua D: resources. We can see the Medicaid spends and we can
Scalora, Joshua D: eventually tie those spends potentially to outcomes we
Scalora, Joshua D: haven't developed that.
Scalora, Joshua D: Framework, but we have the capacity within this tool to do
Scalora, Joshua D: so.
Scalora, Joshua D: The ability to use this information as inputs to our.
Scalora, Joshua D: Dds overall provider performance and quality assurance process.
Scalora, Joshua D: There may be some providers on the meeting if people are
Scalora, Joshua D: familiar with the DDS provider performance review process.
Scalora, Joshua D: There's a large set of information and data that's
Scalora, Joshua D: reviewed with providers every year and the people that design
Scalora, Joshua D: those tools are looking at incorporating some of this
Scalora, Joshua D: information to be.
Scalora, Joshua D: Able to provide additional feedback to providers about.
Scalora, Joshua D: How well they're possibly doing with reporting information to us
Scalora, Joshua D: or supporting individuals access to healthcare. We have new
Scalora, Joshua D: HealthEquity tools and those give us the ability to kind of
Scalora, Joshua D: slice and dice these outcomes that we've been talking about by
Scalora, Joshua D: race, ethnicity, language and other factors such as age.
Scalora, Joshua D: Or gender.
Scalora, Joshua D: Sex and also the ability to automate policy.
Scalora, Joshua D: And audit compliance. For instance, if we get a new rule,
Scalora, Joshua D: I mention the access rule, which will necessitate DDS to revise
Scalora, Joshua D: our procedures for incident reporting. We will have a new
Scalora, Joshua D: requirement around critical incident definitions,
Scalora, Joshua D: specifically around.
Scalora, Joshua D: Suspicion of abuse or neglect. We will be able to work,
Scalora, Joshua D: potentially with our partners in PULSELEY to change the the.
Scalora, Joshua D: The algorithm change the things that we're looking at to expand.
Scalora, Joshua D: Now we're we're going to go broader than our current
Scalora, Joshua D: definition of critical incident.
Scalora, Joshua D: We're going to need to come up with new rules, but we'll be
Scalora, Joshua D: able to, once we feel that we've tuned those rules and that we
Scalora, Joshua D: have a good that we're using the right codes to that, that we're
Scalora, Joshua D: providing comprehensive oversight for people that will
Scalora, Joshua D: be able to autom.
Scalora, Joshua D: That, and that's a powerful thing across the whole system of
Scalora, Joshua D: care.
Scalora, Joshua D: At the individual label.
Scalora, Joshua D: Level we're able to provide new views of the person that we
Scalora, Joshua D: haven't had before. The overlay. A lot of these metrics that I've
Scalora, Joshua D: been talking about, like detected incidents and reported
Scalora, Joshua D: incidents, abuse and neglect events, fatal 5 events,
Scalora, Joshua D: polypharmacy, psych hospitalization and abuse and
Scalora, Joshua D: neglect and exploitation claim.
Scalora, Joshua D: Claims and we're able to see that over time for an
Scalora, Joshua D: individual.
Scalora, Joshua D: And see patterns of of of decline for individuals and
Scalora, Joshua D: hopefully make sure that the right people have access to that
Scalora, Joshua D: information so they can do something to help that person
Scalora, Joshua D: and improve the situation.
Scalora, Joshua D: So there's a lot of possibility with the new tools that we have.
Scalora, Joshua D: And we're very, very hopeful about new ways that we can use
Scalora, Joshua D: it.
Scalora, Joshua D: These these are not Uris that you think are blurry.
Scalora, Joshua D: This is just some proprietary slides of pulse lights.
Scalora, Joshua D: So we're not able to show these screens at this time, but we are
Scalora, Joshua D: excited to find ways to show you the outputs from our system. If
Scalora, Joshua D: we can't exactly show you the the screens themselves at this
Scalora, Joshua D: time, I'd be happy to come back and share some metrics around.
Scalora, Joshua D: Our use of the tools and some of the outcomes, so these tools
Scalora, Joshua D: show us visually.
Scalora, Joshua D: Individual's history over time and they can overlay those
Scalora, Joshua D: things that I was talking about and then be expanded to show the
Scalora, Joshua D: details.
Scalora, Joshua D: So we can actually see the details of what that incident
Scalora, Joshua D: report said when it was reported to us. And we can read the
Scalora, Joshua D: details of that medical treatment and we can read what
Scalora, Joshua D: that abuse, neglect allegation said all in one place.
Scalora, Joshua D: Very, very powerful for us. We use it for the periodic and
Scalora, Joshua D: detection of the unreported incidents and to trend analysis
Scalora, Joshua D: to do trend analysis, looking for patterns that might lead to
Scalora, Joshua D: an intervention like a pattern of non reporting.
Scalora, Joshua D: A provider or a provider location?
Scalora, Joshua D: Right now we're really diving into the review of emergency
Scalora, Joshua D: room and the inpatient visits trying to look for those early
Scalora, Joshua D: warning signs of the critical incidents or other events. And
Scalora, Joshua D: that's what I was kind of just talking about with the admit
Scalora, Joshua D: discharge and transfer data.
Scalora, Joshua D: How else could we use Aura to help people in the future?
Scalora, Joshua D: So right now a pulse light is engaging in a series of
Scalora, Joshua D: trainings for DDS staff.
Scalora, Joshua D: And they're pretty expansive in terms of availability. We cast a
Scalora, Joshua D: broad net and we're really training a diverse group of
Scalora, Joshua D: people from across our system in access to this information, but
Scalora, Joshua D: really focusing a lot on healthcare.
Scalora, Joshua D: Investigations.
Scalora, Joshua D: The quality licensing.
Scalora, Joshua D: Qsr Healthcare and the clinical folks, the clinical staff in the
Scalora, Joshua D: regions are some of our most avid new users. We also
Scalora, Joshua D: partnered with our Director of Equity and Inclusion Doctor
Scalora, Joshua D: Cheryl Ellis, and Doctor Ellis is starting to conduct.
Scalora, Joshua D: Use the equity analysis tools to conduct her own analysis for
Scalora, Joshua D: DDS.
Scalora, Joshua D: Based on some some hypothesis that she has.
Scalora, Joshua D: So it's becoming more broadly utilized by DDS and we're
Scalora, Joshua D: expanding our bench of individuals who can use this
Scalora, Joshua D: information.
Scalora, Joshua D: Pulse lights, also in between the trainings.
Scalora, Joshua D: Offers office hours and those office hours give the
Scalora, Joshua D: opportunity for DDS staff to bring their ideas and questions,
Scalora, Joshua D: problems and needs.
Scalora, Joshua D: Around the use of this information to the pulse light
Scalora, Joshua D: team and have that team work to solve that for them at that
Scalora, Joshua D: time.
Scalora, Joshua D: From my perspective, the analysis of the trends and
Scalora, Joshua D: patterns across the fatal 5 and the adverse conditions is
Scalora, Joshua D: probably one of the most insightful tools that I've ever
Scalora, Joshua D: seen in data.
Scalora, Joshua D: And I think we're really just starting to scratch the surface
Scalora, Joshua D: with our use of these tools.
Scalora, Joshua D: But these tools were developed, at least from our perspective,
Scalora, Joshua D: by.
Scalora, Joshua D: The necessity to utilize claims to better understand.
Scalora, Joshua D: Individuals that we support to make sure that when people are
Scalora, Joshua D: supposed to report things to us, that that's happening and when
Scalora, Joshua D: follow up is supposed to occur for things like critical
Scalora, Joshua D: incidents that are very severe, that that does occur because
Scalora, Joshua D: that allows the prevention of a preventable event.
Scalora, Joshua D: From that allows us to try to prevent that from occurring
Scalora, Joshua D: again and also learn at a system level.
Scalora, Joshua D: So I'm really happy to have been invited here today.
Scalora, Joshua D: By you.
Scalora, Joshua D: I appreciate having the time you gave me a lot of time.
Scalora, Joshua D: I sometimes talk a lot more than I mean to.
Scalora, Joshua D: So it's tough to sum it all up.
Scalora, Joshua D: I could probably talk for a couple of days about these tools
Scalora, Joshua D: that we're using, and I'm not sure I gave you the information.
Scalora, Joshua D: That's the most the thing that's most important to you.
Scalora, Joshua D: So I don't know how much more time you all have for the
Scalora, Joshua D: discussion, but if you wanna take over.
Scheff, Jordan A: So thanks, Josh. If, yeah, I'm just gonna step in.
Scheff, Jordan A: Jordan chef, Commissioner, DDS.
Scheff, Jordan A: So first of all, thank you.
Scheff, Jordan A: I I think in what Josh shared is an important detail.
Scheff, Jordan A: I just want to highlight we went from looking at a tool that
Scheff, Jordan A: would help us do a look back at what was missed.
Scheff, Jordan A: And while we still value and use that part of the tool, we've
Scheff, Jordan A: really pivoted to being able to look forward towards prevention.
Scheff, Jordan A: Identification of concerns that don't need health outcomes that
Scheff, Jordan A: don't need to happen if we can get involved early enough when
Scheff, Jordan A: we see things so well, we'll use it for the the the original
Scheff, Jordan A: intent.
Scheff, Jordan A: It does continue to morph and grow, and not just for us.
Scheff, Jordan A: Well, the work that Josh has done.
Scheff, Jordan A: Other states that Josh and pulsate have done has been
Scheff, Jordan A: adopted in other states who also had really good ideas about how
Scheff, Jordan A: they may leverage the tool further.
Scheff, Jordan A: And so we reap the benefits of.
Scheff, Jordan A: Of the enhancements are very often made for other states that
Scheff, Jordan A: also work for us.
Scheff, Jordan A: And it's, you know, there's there's a resource issue in
Scheff, Jordan A: terms of how?
Scheff, Jordan A: Staff can save a lot of time from going out and doing paper
Scheff, Jordan A: audits of certain things versus having the data presented to
Scheff, Jordan A: them in a digestible format at their desk.
Scheff, Jordan A: So our licensors, instead of spending a day flipping through
Scheff, Jordan A: page by page in a book, they can spend an hour the day before
Scheff, Jordan A: prepping for a licensing visit in, in a lot more time outside
Scheff, Jordan A: of the book to be helping us on our licensing and quality visits
Scheff, Jordan A: the.
Scheff, Jordan A: Amount of time and travel.
Scheff, Jordan A: The number of people we send to a visit.
Scheff, Jordan A: With a limited number of nurses who can really leverage that
Scheff, Jordan A: during the nursing and other staffing shortages.
Scheff, Jordan A: So I like the if the Council has any questions for marlai Malika
Scheff, Jordan A: or Josh.
Scheff, Jordan A: To go ahead and fire away.
Scheff, Jordan A: If that's all right with you, Patty and I, I think Patty's
Scheff, Jordan A: been having some trouble getting bounced off and on and has been
Scheff, Jordan A: polite about it.
Scheff, Jordan A: So I don't know if you're on Patty at the moment.
Scheff, Jordan A: So with her not present at the moment and having some
Scheff, Jordan A: difficulties, or at least not able to speak at the moment.
Bronson, Kevin: Commissioner, she is.
Bronson, Kevin: She just probably is on your other screen.
Scheff, Jordan A: OK, she may be.
Scheff, Jordan A: There she is.
Scheff, Jordan A: But she's muted.
Scheff, Jordan A: And she can't talk.
Scheff, Jordan A: I see her lips moving, OK?
Scheff, Jordan A: So we're going to work on that.
Scheff, Jordan A: Are you OK if I sort of facilitate questioning? She's
Scheff, Jordan A: nodding along with me.
Scheff, Jordan A: So anybody have any questions for the team?
Scheff, Jordan A: Not seeing any. Oh deedre.
Deidre Toole: Hi, I'm Deidre, tool council.
Deidre Toole: This is all new information for me, so it's it's a lot of
Deidre Toole: acronyms and a lot of new different departments et cetera.
Deidre Toole: But I I find it really fascinating and it seems
Deidre Toole: incredible we can be doing all this to help identify
Deidre Toole: individuals at risk. My question is, is.
Deidre Toole: What ages are we starting with identifying individuals and
Deidre Toole: looking at their history?
Deidre Toole: Are we going back to birth and history of DCF in their lives?
Deidre Toole: I didn't know like how.
Deidre Toole: Early this how how far back we're going. Are we looking at
Deidre Toole: during their school age time or looking at 18 and up only?
Deidre Toole: I just didn't know what the age group was for this.
Scalora, Joshua D: Like an age cutoff.
Scalora, Joshua D: It's people that we have the authority to look at, so if it's
Scalora, Joshua D: someone that's in adds waiver, they're enrolled on the DDS
Scalora, Joshua D: waiver, getting adds residential service on the DDS waiver.
Scalora, Joshua D: We're looking at them.
Scalora, Joshua D: We're not going backwards and doing like life history reviews
Scalora, Joshua D: or anything like that, but we have data from the person's
Scalora, Joshua D: Medicaid enrollment from 2015. I believe in our system.
Scalora, Joshua D: Yeah, but we don't go back and replenish that data.
Scheff, Jordan A: Almost.
Scalora, Joshua D: So you know, we as new people come into our system.
Scalora, Joshua D: There in our system, and they're always in the Medicaid system at
Scalora, Joshua D: DSS.
Scalora, Joshua D: So we match our people up with their people and that's how we.
Scalora, Joshua D: Use that data.
Deidre Toole: So I just because I work in a school system. I, you know, I
Scalora, Joshua D: Yeah.
Deidre Toole: think from birth to 22, the incidence of DCF in some of my
Deidre Toole: individuals lives and what's been happening with them
Deidre Toole: medically and also use neglect, it seems like it would be an
Deidre Toole: important piece.
Deidre Toole: Of data to follow up on at some point, but maybe not.
Scalora, Joshua D: Yeah. So DCF is not Medicaid funded.
Scalora, Joshua D: And so the Commissioner chef is very, I'll just say, commit, I
Deidre Toole: Hey.
Scalora, Joshua D: know, Commissioner Chef is interested in sharing the the
Scalora, Joshua D: good news of what he's been able to learn by using this
Scalora, Joshua D: information with his colleagues at other agencies.
Scheff, Jordan A: We are we.
Scheff, Jordan A: We we are working hard to ask our sister agencies involved in
Scheff, Jordan A: the Medicaid space. So D, Miss DSS potentially DCF because a
Scheff, Jordan A: number of their kids do get Medicaid, but any of our
Scheff, Jordan A: partners birth to three or office of early childhood.
Scheff, Jordan A: We think.
Scheff, Jordan A: If the Medicaid dollars are spent on them and we have
Scheff, Jordan A: Medicaid data that can help us learn something, I personally
Scheff, Jordan A: believe we should be harnessing that for dozens and dozens of
Scheff, Jordan A: years.
Scheff, Jordan A: States in the country sat on piles of piles of data that
Scheff, Jordan A: could really inform a better outcome and a better lives for
Scheff, Jordan A: folks without any real ability to do much with it.
Scheff, Jordan A: 'Cause it's it's mountainous and I don't know Malika, if you have
Scheff, Jordan A: any idea.
Scheff, Jordan A: In the state of Connecticut, how many data points we're talking
Scheff, Jordan A: about that you've ingested?
Scheff, Jordan A: But it's you have a ballpark.
Mallika Thanky: Over a billion, I think we have over a billion records now.
Mallika Thanky: That's for all of Medicaid, though. For your population it's
Mallika Thanky: significantly smaller, but it's a lot.
Scheff, Jordan A: That's for Connecticut, right?
Mallika Thanky: Yep.
Scheff, Jordan A: So every state has Medicaid data and it just sits in stacks and
Scheff, Jordan A: drawers, and no one knows how to. No one was harnessing it.
Scheff, Jordan A: And now we can.
Scheff, Jordan A: And to have that's and that's my point. If you can have
Scheff, Jordan A: information that can help you do a better job at your fingertips,
Scheff, Jordan A: it's right there at your fingertips.
Scheff, Jordan A: No one has to do a desk on it.
Scheff, Jordan A: It's it's. It's pretty powerful it for me. If I could go back 30
Scheff, Jordan A: years and have access to this data.
Scheff, Jordan A: Regard to things I might have prevented and the things we're
Scheff, Jordan A: preventing now.
Scheff, Jordan A: Josh has a staff that works for him, so in addition to some of
Scheff, Jordan A: the other people who are starting to get involved, we
Scheff, Jordan A: review cases weekly and we are routinely and we have found some
Scheff, Jordan A: things we have found some curious things in the data that
Scheff, Jordan A: made us go.
Scheff, Jordan A: Back and ask a question that led to a better outcome for an
Scheff, Jordan A: individual.
Scheff, Jordan A: I know of that particular story 'cause I heard it directly.
Scheff, Jordan A: I know that that story occurs over and over and over now.
Scheff, Jordan A: And it did not occur three years ago. We didn't.
Scheff, Jordan A: We didn't know how to do that. We couldn't do that.
Scheff, Jordan A: We have no eyes on that data.
Scheff, Jordan A: So to me, if we, you know, it's like that starfish sort of poem,
Scheff, Jordan A: right?
Scheff, Jordan A: If you may not matter to all the starfish, but it matters to that
Scheff, Jordan A: one if we can help one person have a better life through
Scheff, Jordan A: harnessing that data. It's incumbent upon us to do so.
Scheff, Jordan A: And that's my message to my colleagues when I talk about
Scheff, Jordan A: this.
Scheff, Jordan A: Adrian.
aadriennebb@gmail.com: Yes. Am I on?
aadriennebb@gmail.com: Hi. Hello. Adrian. Benjamin, councilmember. First of all,
Scheff, Jordan A: I'm like Yep.
aadriennebb@gmail.com: this is amazing and I'm really impressed. And when I heard
aadriennebb@gmail.com: there was a presentation about Pulse light, I thought, what is
aadriennebb@gmail.com: that?
aadriennebb@gmail.com: But now I know.
aadriennebb@gmail.com: So thank you.
aadriennebb@gmail.com: Two questions.
aadriennebb@gmail.com: One is for someone that has both private insurance and Medicaid.
aadriennebb@gmail.com: At least my own personal situation with my daughter. She
Scalora, Joshua D: Yeah.
aadriennebb@gmail.com: has private insurance and Medicaid, so private insurance
aadriennebb@gmail.com: is built first.
aadriennebb@gmail.com: Do you get that data?
Scalora, Joshua D: We can't get the private through.
aadriennebb@gmail.com: Boo, yes.
Scalora, Joshua D: Through Medicaid, we don't get private through Medicaid. That's
Scalora, Joshua D: right.
Scalora, Joshua D: So I won't get into it too much, but there's another supplemental
Scalora, Joshua D: data source that we're getting the ADT data from the admit
Scalora, Joshua D: discharge transfer.
Scalora, Joshua D: That's Connie to the state's health information exchange. Too
aadriennebb@gmail.com: Oh yes, I know that time.
Scalora, Joshua D: many.
Scalora, Joshua D: It's another.
Scalora, Joshua D: It's an I know.
Scalora, Joshua D: Next time I'll bring a diagram.
aadriennebb@gmail.com: I know that, Connie.
Scalora, Joshua D: I know, I apologize.
Scalora, Joshua D: But basically.
Scalora, Joshua D: If our medical information in the state of Connecticut goes
Scalora, Joshua D: into an electronic health record system, it's supposed to get
Scalora, Joshua D: transferred to the health information exchange and that's
Scalora, Joshua D: all.
Scalora, Joshua D: All medical, no matter private. Whoever pays all payers right.
Scalora, Joshua D: So we maybe in the future be able to bring that in, but right
Scalora, Joshua D: now through the authority that we have to access information,
Scalora, Joshua D: we don't have access to that.
Scheff, Jordan A: We are in pursuit of Medicare data 'cause about 40% of our
Scheff, Jordan A: population is duly enrolled in Medicaid and Medicare.
Scheff, Jordan A: So we're in the process of trying to incorporate that
Scheff, Jordan A: Pennsylvania's gonna beat us to the punch.
Scheff, Jordan A: They may have already done it and I'll be jealous of Kristen
Scheff, Jordan A: and her team there for pushing that with their Medicaid
Scheff, Jordan A: organization, but we're we're we're on.
Scheff, Jordan A: We're on the way.
Scalora, Joshua D: And I have to say I have to apologize.
Scalora, Joshua D: I do have to run, but I might be able to stay for your last
Scalora, Joshua D: question, just there may be more questions that I if it's OK,
Scalora, Joshua D: I'll be happy to follow up with you on.
Scheff, Jordan A: Was there one more Adrian?
Scalora, Joshua D: Wonderful.
Scheff, Jordan A: Nope, you're good right now.
Scalora, Joshua D: OK.
Scheff, Jordan A: All right.
Scalora, Joshua D: Thank you so much.
Scheff, Jordan A: Thanks Josh.
Scheff, Jordan A: Thanks Malika and I I lost him.
aadriennebb@gmail.com: Thank you.
Scheff, Jordan A: Malai moral. Oh, there he is.
Scalora, Joshua D: Raleigh, murali's there.
Scheff, Jordan A: He's next to Malika.
Scheff, Jordan A: You moved around during the presentation.
Scheff, Jordan A: Thank you for attending.
Scheff, Jordan A: I'm sure that we'll have other opportunities to talk about this
Scheff, Jordan A: more, but I I want to thank Josh.
Scheff, Jordan A: He gives me a lot of credit for leadership on this, but we have.
Scheff, Jordan A: Josh has been pushing this.
Scheff, Jordan A: Gentle, steady pressure for a number of years and it's one of
Scheff, Jordan A: those things that's hard to see how it's going to pay off
Scheff, Jordan A: because you're in the weeds of it and he's deep and deeply in
Scheff, Jordan A: the weeds. But we have pushed and pushed and pushed and we're
Scheff, Jordan A: real.
Scheff, Jordan A: Outcomes, and I think for friends at the Office of the
Scheff, Jordan A: Inspector General, they certainly would have liked us to
Scheff, Jordan A: go faster. But I think given the way the, the, the new rule from
Scheff, Jordan A: CMS, the access rule is written indicates to us.
Scheff, Jordan A: That they've liked what we've done and they'd like more states
Scheff, Jordan A: to do something like what we've done.
Scheff, Jordan A: They're gonna set the floor.
Scheff, Jordan A: This this product will go far beyond the floor, but.
Scheff, Jordan A: We we think that that we have led here pretty strongly and
Scheff, Jordan A: recognized for the work we could have just made an Excel and
Scheff, Jordan A: access thing that was 500 pages long and sat somebody in a
Scheff, Jordan A: corner to pour through it and see if they saw anything
Scheff, Jordan A: interesting and.
Scheff, Jordan A: As my friend John Martin, who's also looked into this product
Scalora, Joshua D: Yep.
Scheff, Jordan A: quite a bit says.
Scheff, Jordan A: Just because it's interesting doesn't mean it's important.
Scheff, Jordan A: What we can learn here is that the things.
Scheff, Jordan A: I have to use.
Scheff, Jordan A: I use that all the time to reframe because I go down rabbit
Scalora, Joshua D: Yeah, me too.
Scheff, Jordan A: holes. Right. It's interesting.
Scheff, Jordan A: But is it important?
Scheff, Jordan A: Let's move on to the next thing.
Scheff, Jordan A: So, Jonathan, I think about that phrase from John often, but it
Scheff, Jordan A: helps us see what's important in right away it it pops. Christina
Scheff, Jordan A: Latimer, who didn't join us tonight for the presentation,
Scheff, Jordan A: works for Josh and she is rifling through incidents at a
Scheff, Jordan A: rate we never could have done.
Scheff, Jordan A: Follow up before.
Scheff, Jordan A: And we're going to get to automated push notifications.
Scheff, Jordan A: And there's more and more to come.
Scheff, Jordan A: But thank you to the team.
Scheff, Jordan A: Thank you for to our friends at Pulse Light Nora, and to you,
Scheff, Jordan A: Josh, for showing up and sharing tonight.
Scheff, Jordan A: I appreciate you.
Scalora, Joshua D: Thanks so much everyone.
Scalora, Joshua D: Have a great evening. Take care.
Patti Silva: Alright, Patty Silver, Council chair.
Patti Silva: Can everybody hear me?
Scheff, Jordan A: Yes, we can.
Patti Silva: I know, but I, you know, I can't push any of the buttons.
Patti Silva: I can't mute.
Patti Silva: I can't.
Patti Silva: Whatever. So but OK.
Patti Silva: That was great.
Patti Silva: Thank you Jordan for for arranging that that that was so
Patti Silva: interesting.
Patti Silva: Of course, a billion and one questions. But.
Patti Silva: Great, great presentation.
Scheff, Jordan A: Thank you.
Patti Silva: Next item on our agenda is the Ombudsperson report.
Patti Silva: Shannon, you are up.
Jacovino, Shannon: Everyone, this is Shannon Giacavino, DDS on budsperson.
Jacovino, Shannon: I did send out my written report yesterday.
Jacovino, Shannon: I didn't receive any questions from anybody or any particular
Jacovino, Shannon: issues. People wanted me to address.
Jacovino, Shannon: I will say that it was a month.
Jacovino, Shannon: That was maybe somewhat less busy than the past few months
Jacovino, Shannon: have been.
Jacovino, Shannon: I'm not quite sure why that is, but you know somewhat fewer
Jacovino, Shannon: contacts.
Jacovino, Shannon: You know, I didn't notice any particular trends this month
Jacovino, Shannon: except, you know, the one that I've been talking to you about
Jacovino, Shannon: for the past three years, which is that, you know, the staffing
Jacovino, Shannon: crisis is really having an impact on just about every
Jacovino, Shannon: aspect of people's services and.
Jacovino, Shannon: Their lives and most of the calls that I get.
Jacovino, Shannon: In some way sort of relate back to the staffing crisis. So I
Jacovino, Shannon: didn't want to make everyone aware.
Jacovino, Shannon: That, you know their public Act 23 Dash 137 was passed.
Jacovino, Shannon: In the 2023 legislative session, and there are going to be a lot
Jacovino, Shannon: of the reports that were included in that bill, including
Jacovino, Shannon: the report that addresses the career pipeline are going to be
Jacovino, Shannon: coming due and are going to be part of the discussion this year
Jacovino, Shannon: and.
Jacovino, Shannon: The legislature and I think it's really important for.
Jacovino, Shannon: All of you and individuals and families to make sure that
Jacovino, Shannon: you're a part of those discussions because.
Jacovino, Shannon: I can't think of a more important issue for people to be
Jacovino, Shannon: addressing. You know, I think Josh talked a little bit about
Jacovino, Shannon: the fact that.
Jacovino, Shannon: I am seeing an increase in the calls that I'm getting around
Jacovino, Shannon: people who are in emergency rooms.
Jacovino, Shannon: The hospitals are very anxious to move people along. In many
Jacovino, Shannon: cases, there's really not any place for people to go.
Jacovino, Shannon: They can't return back to their home.
Jacovino, Shannon: They can't return back to the program that they're in. I think
Jacovino, Shannon: DDS is doing what they can to try to manage this, but I think
Jacovino, Shannon: with all of these issues, I think DDS has been very
Jacovino, Shannon: responsive.
Jacovino, Shannon: But I don't think that these are necessarily issues that.
Jacovino, Shannon: Our DDS is to solve.
Jacovino, Shannon: Alone.
Jacovino, Shannon: So yeah, I would just encourage you to all stay aware and to
Jacovino, Shannon: really be paying attention next legislative session because all
Jacovino, Shannon: of these issues are going to be discussed and you know it. It is
Jacovino, Shannon: just so critical for people in our community to to be talking
Jacovino, Shannon: about how.
Jacovino, Shannon: This is impacting them.
Jacovino, Shannon: Does anybody have any? Oh, Adrian.
aadriennebb@gmail.com: Hi, thank you. Adrian Benjamin, Council member.
aadriennebb@gmail.com: I'm gonna give a little shout out to the agency. My daughter's
aadriennebb@gmail.com: involved with it, just called hark. And I'm not saying it's a
aadriennebb@gmail.com: perfect agency, but they made the decision a few months ago to
aadriennebb@gmail.com: raise the wages, even though that state that raised did not
aadriennebb@gmail.com: come from.
aadriennebb@gmail.com: The state so the wages are now $19.00 an hour for people in
aadriennebb@gmail.com: Group homes in 1850 for day programs.
aadriennebb@gmail.com: What has happened is that there.
aadriennebb@gmail.com: Their vacancy rate for staff went from like 45%.
aadriennebb@gmail.com: 8% they've hired so many people. They also included increased
aadriennebb@gmail.com: something in their.
aadriennebb@gmail.com: I guess the health benefits, I don't know exactly what the
aadriennebb@gmail.com: details of that, but you know I remember hear people saying
aadriennebb@gmail.com: well, there's just people that don't want to work in this field
aadriennebb@gmail.com: and obviously that's true.
aadriennebb@gmail.com: But raising wages helps and we should get the word out to the
aadriennebb@gmail.com: agencies.
aadriennebb@gmail.com: We're involved with that. If they can do that.
aadriennebb@gmail.com: Or or work hard to figure out a way to do that.
aadriennebb@gmail.com: It might.
aadriennebb@gmail.com: It it will help.
aadriennebb@gmail.com: It's not, obviously.
aadriennebb@gmail.com: Is that a livable wage? Is in Connecticut? Nope.
aadriennebb@gmail.com: Does that mean nobody else is gonna, that they're not gonna
aadriennebb@gmail.com: have a second job or part time job, but it's progress and it
aadriennebb@gmail.com: and it's really shown up in the staffing.
aadriennebb@gmail.com: So that's my message.
Michael Beloff: Thanks Mike Bellaf Michael Belloff, Council member, and
Michael Beloff: Shannon.
Michael Beloff: I just want to make sure.
Michael Beloff: Just a quick question about your role. Sometimes when I get weird
Michael Beloff: questions, people will say something. You know they're
Michael Beloff: having an issue or with applying or appealing.
Michael Beloff: And I just send them to you.
Michael Beloff: I just wanna make sure that's the proper. I don't that I'm
Jacovino, Shannon: Mm hmm.
Michael Beloff: overburdening you. When when people have questions in that
Michael Beloff: way.
Michael Beloff: That was that was the first question.
Michael Beloff: The other was and this may be more for the end. I know one of
Michael Beloff: the big reports that being done is, you know, doing the research
Michael Beloff: into.
Michael Beloff: Whether IQ should be part of intellectual disability, and I
Michael Beloff: was wondering if.
Michael Beloff: If there's going to be a point where we're going to get an
Michael Beloff: update on preliminary findings or what might be in that report
Michael Beloff: or what that looks like.
Jacovino, Shannon: Sure. So this is Shanna Giacovino, DDS and buds person.
Jacovino, Shannon: So for the first part of your question, send people my way. I
Jacovino, Shannon: mean, that's what I'm here for.
Jacovino, Shannon: And if they're having a hard time figuring something out.
Jacovino, Shannon: And they're coming to you. Then the chances are that even if I
Jacovino, Shannon: don't know the answer, it's going to be a lot easier for me
Jacovino, Shannon: to get that figured out for them than it is if they continue to
Jacovino, Shannon: try to grapple with that on their own.
Jacovino, Shannon: So absolutely, you're never bothering me by sending people
Jacovino, Shannon: my way.
Jacovino, Shannon: You're helping me to earn my pay.
Jacovino, Shannon: As far as the other question, I know that.
Jacovino, Shannon: Opm is responsible for the report on the.
Jacovino, Shannon: Potentially changing the definition.
Jacovino, Shannon: I know that they're working on the report.
Jacovino, Shannon: I was a part of.
Jacovino, Shannon: A work group that reviewed they had they hired a consultant to
Jacovino, Shannon: come in and sort of do a review of what's happening in other
Jacovino, Shannon: states.
Jacovino, Shannon: And you know, just sort of try to outline all of the options
Jacovino, Shannon: for Connecticut.
Jacovino, Shannon: I don't know when that report will be released, but I know
Jacovino, Shannon: that.
Jacovino, Shannon: It should be.
Jacovino, Shannon: Soon, I think.
Jacovino, Shannon: I think the due date has come and gone, but there was an
Jacovino, Shannon: extension on that.
Jacovino, Shannon: When it will be made public or how it will be made public, I
Jacovino, Shannon: don't know.
Jacovino, Shannon: But I I'm I'm guessing you'll be. You'll be Privy to that
Jacovino, Shannon: information as soon as it's able to be made public, because a lot
Jacovino, Shannon: of people are waiting to hear that information.
Michael Beloff: I I think originally the report was due in January, so I know
Michael Beloff: it's not.
Michael Beloff: I don't think it's due yet for that particular item.
Michael Beloff: But.
Michael Beloff: You know, of course my my concern is that they always is.
Michael Beloff: If if the definition has changed and more money is not given to
Michael Beloff: DDS, you know that can cause problems as well.
Jacovino, Shannon: Right. Well, I don't.
Jacovino, Shannon: I mean I I guess I would say that changing the definition, we
Jacovino, Shannon: don't know what the impact of that would be on DDS or you
Jacovino, Shannon: know, where services like there's there's a lot more to
Jacovino, Shannon: that issue.
Jacovino, Shannon: Than just money.
Jacovino, Shannon: And so I think that when the report is released, I'm sure
Jacovino, Shannon: that there's going to be discussions about that and the
Jacovino, Shannon: legislature and those are the areas where I think it's really
Jacovino, Shannon: important for people to be taking to be paying attention.
Jacovino, Shannon: And to be taking advantage of the opportunity to provide your
Jacovino, Shannon: own input.
Jacovino, Shannon: On those issues.
Jacovino, Shannon: So I think you'll have those opportunities Kevin Bronson
Jacovino, Shannon: saying the due date is January 1st, 2025. My apologies.
Jacovino, Shannon: I thought they asked for an extension on that one.
Patti Silva: Maddie Silva, Council chair.
Patti Silva: Does anyone have any other questions for Shannon?
Patti Silva: OK.
Patti Silva: We'll move along. Thank you, Shannon.
Jacovino, Shannon: No problem.
Patti Silva: Next up is Commissioner.
Scheff, Jordan A: Jordan chef, Commissioner, DDS, our friends from Pulse light
Scheff, Jordan A: aura looking always to learn more about what they can learn,
Scheff, Jordan A: have asked if they could stay on and of course as a public
Scheff, Jordan A: meeting I welcome them and as as valued partners, I welcome them
Scheff, Jordan A: as well they can gain.
Scheff, Jordan A: Some insight, so thank you for sticking around both of you.
Scheff, Jordan A: One of the things I wanted to make sure the pulse light
Scheff, Jordan A: presentation that was clear that the the the Slicer dicer which
Scheff, Jordan A: is hard to visualize in the blurred image is.
Scheff, Jordan A: Because we weren't able to de identify it in a way that would
Scheff, Jordan A: make it shareable, and it's also proprietary to pulse light and
Scheff, Jordan A: the public facing meetings.
Scheff, Jordan A: So there's a number of reasons.
Scheff, Jordan A: That's obscured that way, but that we can look at trends by
Scheff, Jordan A: person, by location.
Scheff, Jordan A: You know, a single group home by an agency.
Scheff, Jordan A: We can also do it by ZIP code.
Scheff, Jordan A: And there's a number of things. And, you know, we looked at some
Scheff, Jordan A: of the most recent data and I looked at claims and I could
Scheff, Jordan A: drill down on a person who I used to support in private
Scheff, Jordan A: sector, and I could see a history that was just so Val.
Scheff, Jordan A: To see.
Scheff, Jordan A: Her progression as she aged and why certain resources were
Scheff, Jordan A: needed and you know I could I I could see a lot just from the
Scheff, Jordan A: claims data in getting to understand a little bit better
Scheff, Jordan A: about where she's at.
Scheff, Jordan A: That's incredibly valuable to our our, my my boots on the
Scheff, Jordan A: ground staff who are trying to balance resources.
Scheff, Jordan A: There's also another point we didn't highlight much, but I
Scheff, Jordan A: think is important to note in what was shared is there's we
Scheff, Jordan A: can make we, we've always looked at how we fund individuals in a
Scheff, Jordan A: vacuum.
Scheff, Jordan A: What does DDS funding?
Scheff, Jordan A: This allows us to see total Medicaid spend on an individual
Scheff, Jordan A: across multiple settings.
Scheff, Jordan A: So if you have someone who has in home supports you know less
Scheff, Jordan A: than 24 hour supports and attends a day program, there's a
Scheff, Jordan A: lot you you you may not know about them.
Scheff, Jordan A: And we make decisions on what we agree to fund based on just
Scheff, Jordan A: that.
Scheff, Jordan A: But now that we can see medical history and other events in
Scheff, Jordan A: their lives through Medicaid claiming we get a better
Scheff, Jordan A: picture.
Scheff, Jordan A: And sometimes I think our partnership with DSS on this is
Scheff, Jordan A: important.
Scheff, Jordan A: Because one of us is going to pay one way or the other for a
Scheff, Jordan A: persons needs, and we were making those decisions not
Scheff, Jordan A: knowing what the rest of Medicaid may be spending on an
Scheff, Jordan A: individual.
Scheff, Jordan A: And now we can really look at it holistically and ensure that
Scheff, Jordan A: we're not being Pennywise and # foolish when we can pull members
Scheff, Jordan A: from those other agencies together to, say, listen, this
Scheff, Jordan A: person has an unmet need.
Scheff, Jordan A: What's the best way to go about it?
Scheff, Jordan A: You spending the money?
Scheff, Jordan A: Us spending the money.
Scheff, Jordan A: It it it really does, I think benefit outcomes for
Scheff, Jordan A: individuals.
Scheff, Jordan A: But like Josh, I spend hours talking about pulse light and
Scheff, Jordan A: can spend hours more just 'cause. It's probably the most
Scheff, Jordan A: innovative tool for what we do I've ever seen.
Scheff, Jordan A: So I'm gonna shift a little bit to a tool that right now isn't
Scheff, Jordan A: working for a lot of people.
Scheff, Jordan A: Talk a little bit about how I spent my time this month. Many
Scheff, Jordan A: of you, particularly those of you who spend time with other
Scheff, Jordan A: parents, providers.
Scheff, Jordan A: And others are aware of the ongoing issues we are having
Scheff, Jordan A: with our fiscal intermediary.
Scheff, Jordan A: We continue to pound through.
Scheff, Jordan A: It affects providers too.
Scheff, Jordan A: We continue to work through those issues in close concert
Scheff, Jordan A: with our partners at DSS.
Scheff, Jordan A: And done a couple things to try and make those outcomes better,
Scheff, Jordan A: including investing in a key staff person to coordinate for
Scheff, Jordan A: us at a statewide level for DDS, Joe Carvalho has come back to
Scheff, Jordan A: DDS specifically right now as a senior consultant to my office
Scheff, Jordan A: senior policy advisor.
Scheff, Jordan A: Spending most of his time right now on Pulse on GTI related
Scheff, Jordan A: issues or escalation.
Scheff, Jordan A: Daily contact with the vendor. We've also brought in
Scheff, Jordan A: consultancy through Deloitte to assist with trying to mitigate
Scheff, Jordan A: some of the the negatives that families are encountering. While
Scheff, Jordan A: I say that there's a number of people who are thrilled with the
Scheff, Jordan A: product and the way it works, but there are.
Scheff, Jordan A: Enough people who are unhappy that it's getting.
Scheff, Jordan A: Its due attention. I don't it's.
Scheff, Jordan A: I don't.
Scheff, Jordan A: It's sensationalized in anyway.
Scheff, Jordan A: I think there are true issues, but we continue to work on
Scheff, Jordan A: those.
Scheff, Jordan A: So I spent a lot of last month focused on that.
Scheff, Jordan A: We are in close concert with the governor's office in OPM as we
Scheff, Jordan A: are formulating the budget that will drop when the governor is
Scheff, Jordan A: ready to share it. And with that, any policy initiatives he
Scheff, Jordan A: plans to include.
Scheff, Jordan A: But we don't have anything to share on that yet because it's
Scheff, Jordan A: all.
Scheff, Jordan A: It is a publicly yet known information and that's, you
Scheff, Jordan A: know, when the governor's ready, the governor will share.
Scheff, Jordan A: As we get ready to head into session in January.
Scheff, Jordan A: That has been where I've spent a fair amount of my time. I also.
Scheff, Jordan A: Have had the honor and privilege of visiting a number of
Scheff, Jordan A: locations over the last four or five weeks, six weeks, 7 weeks.
Scheff, Jordan A: It blends together.
Scheff, Jordan A: And for staff recognition.
Scheff, Jordan A: DSP direct support, professional appreciation in our public
Scheff, Jordan A: sector.
Scheff, Jordan A: I know there were a lot of events in the private sector as
Scheff, Jordan A: well, and today I was at our S region staff recognition.
Scheff, Jordan A: Event which we held down at Harkness. Rare that we get
Scheff, Jordan A: together, everyone or most everyone in person to celebrate
Scheff, Jordan A: accomplishments, to commiserate over challenges.
Scheff, Jordan A: And they were able to do that and I was able to visit with
Scheff, Jordan A: them for a bit and got to visit with the Self Advocate
Scheff, Jordan A: coordinators as well.
Scheff, Jordan A: And a couple of them who I have not seen in some time.
Scheff, Jordan A: So that is how I spent most of the last month, and I'm gonna
Scheff, Jordan A: cut myself short there and open it for questions.
Scheff, Jordan A: And I see Kevin's hand just up.
Bronson, Kevin: Yeah. Thanks, Commissioner. Kevin Bronson.
Bronson, Kevin: Dds, the one thing I just wanted to add to the group was that for
Bronson, Kevin: the guardians and individuals on this call, you should have
Bronson, Kevin: received in snail mail a flyer to the upcoming stakeholder
Bronson, Kevin: forums, which are going to be happening next week. And I'm
Bronson, Kevin: happy to drop a.
Bronson, Kevin: Link in the chat. So just just want to add that in.
Scheff, Jordan A: So I'll come up for air there and and and pause see if there
Scheff, Jordan A: are any questions that you may have for me.
Scheff, Jordan A: Before we move on to anything else in the agenda.
Scheff, Jordan A: So, Josh, where are you out 'cause. Usually you got all
Scheff, Jordan A: sorts of questions for me, but maybe he wore you out.
Scheff, Jordan A: If that's the case, I'm gonna bring them every month.
Scheff, Jordan A: I.
Scheff, Jordan A: Don't hear any other questions.
Scheff, Jordan A: Patty Jordan, chef Commissioner, I'll yield back to you.
Patti Silva: Alright, Adiosa council chair. Next on our agenda.
Patti Silva: Thank you, Commissioner.
Patti Silva: Is our bylaws.
Patti Silva: So at last meeting.
Patti Silva: You guys had the opportunity.
Patti Silva: I had to bow out early, but I understand that you guys went
Patti Silva: through the changes in the bylaws and I don't.
Patti Silva: I haven't heard from anybody that there were any concerns
Patti Silva: with with the updates, so if everybody is in agreement.
Patti Silva: Somebody want to make a motion to adopt the updated bylaws.
Michael Beloff: So moved.
Patti Silva: OK, Michael. And is there a second?
aadriennebb@gmail.com: I had a question.
Scheff, Jordan A: I see Christine waving her hand. I think that's a second.
Patti Silva: Christy, Christy. OK, Christine.
aadriennebb@gmail.com: OK, whatever.
Patti Silva: All in favor?
Patti Silva: Say aye. Aye, OK. Any opposed?
Deidre Toole: Right.
Patti Silva: OK, there being none, the motion passes to adopt the amended
Patti Silva: bylaws.
Patti Silva: Thank you, everybody. And Next up is discussion like to form a
Patti Silva: nominating committee for.
Patti Silva: It's that time of year.
Patti Silva: For.
Patti Silva: The Executive Board it would be for the the Chair, Vice Chair
Patti Silva: and secretary position, and we usually will vote at our
Patti Silva: December meeting.
Patti Silva: I believe it is.
Patti Silva: So we would need.
Patti Silva: Several people to form a nominating committee and.
Patti Silva: Usually what they do is.
Patti Silva: Try to work together to come up with a list of people to
Patti Silva: nominate.
Patti Silva: Sometimes they will talk to people who are who have been
Patti Silva: doing it, see if there's an interest in continuing or if
Patti Silva: there are people who are interested in jumping in.
Patti Silva: So if there's anybody that is interested, it's usually I think
Patti Silva: about 3-3 or four people so.
Patti Silva: Do we have some volunteers to form a nominating committee?
Patti Silva: All right, Adrian. Pam.
aadriennebb@gmail.com: And Diana?
Patti Silva: I drink Pam and Diana.
aadriennebb@gmail.com: We're professionals.
Patti Silva: This kind of sounds.
aadriennebb@gmail.com: We've done this before.
Patti Silva: Sounds familiar?
Patti Silva: Is there anybody else?
aadriennebb@gmail.com: With.
Patti Silva: OK, wonderful.
Patti Silva: Thank you, ladies.
Patti Silva: So you guys know your job, so.
Patti Silva: I'll leave it in your very capable hands.
Patti Silva: Thank you so much.
Patti Silva: And then, Christine, you had something very quickly to
Patti Silva: deviate just very, very quickly from from our agenda about
Patti Silva: transportation.
Christine (Guest): Sure. It's Christine Haynesworth, Strauss
Christine (Guest): councilmember.
Christine (Guest): Yes, you haven't heard from me yet tonight. Aren't you
Christine (Guest): surprised?
Christine (Guest): But quickly, the Transportation Committee, after a year, we have
Christine (Guest): a meeting.
Christine (Guest): And they're apparently thank you to Kevin.
Christine (Guest): I can't see your little square, Kevin, but I know you're there.
Christine (Guest): Thank you for helping.
Christine (Guest): They are having an open forum that is, I guess being run by
Christine (Guest): the hired contractor for the dot to speak to issues to get
Christine (Guest): information about what the issues might be within our
Christine (Guest): community.
Christine (Guest): And it's October 28th from 11:50 AM or a second session, October
Christine (Guest): 29th, 6:30 to 8:30.
Christine (Guest): PMI could forward the link to Wes if she could send it out to
Christine (Guest): everybody.
Christine (Guest): Because it's not something I can call out and I can't find it
Christine (Guest): anywhere else. So.
Christine (Guest): Please send out to anybody else that you think might have.
Christine (Guest): Transportation issues or suggestions or things that we
Christine (Guest): can improve our community.
Christine (Guest): Thank you so much.
Patti Silva: Thank you. Christine. Patty Silva, Council chair and next on
Patti Silva: our agenda is.
Patti Silva: The November joint meeting with the racks, that's a a meeting
Patti Silva: that we do every year and we invite the regional advisory
Patti Silva: councils to attend and typically.
Patti Silva: The is it regional directors or if the directors aren't
Patti Silva: available, it might be the the rack chairs that will give a
Patti Silva: report on.
Patti Silva: That's been going on in their regions, that sort of thing. Is
Patti Silva: that correct, Jordan?
Scheff, Jordan A: Board and Chef Commissioner, DDS.
Scheff, Jordan A: Yeah, I believe that is correct.
Patti Silva: And we also.
Patti Silva: Will Jordan, you said you were going to do something about the
Patti Silva: wait list, correct?
Scheff, Jordan A: Yeah, the, the the Statute on the joint meeting asks me to
Scheff, Jordan A: report out on the wait list once annually to a joint meeting of
Scheff, Jordan A: the racks and Council, and that's that is what we will do.
Patti Silva: Right. And then once we're done with that portion of the the
Patti Silva: meeting, then we go into our our regular meeting and if the
Patti Silva: people from the racks want to stand as members of the public,
Patti Silva: they can do that as well, so.
Patti Silva: So that is really what the the joint meeting is about and hope
Patti Silva: everybody will be able to attend.
Patti Silva: It's it's nice to see what's happening around the state and
Patti Silva: get to know some of the people who were involved in the other
Patti Silva: areas so.
Patti Silva: Then.
Patti Silva: The last thing I had was I was working on.
Patti Silva: Trying to update my Member directory and this one goes back
Patti Silva: pretty far and I wanted to just get a a feel for how you guys
Patti Silva: thought about.
Patti Silva: Sharing your information as far as like a phone number, e-mail,
Patti Silva: just among council members. So that in case you wanted to give
Patti Silva: somebody a call or something like that, we would have that
Patti Silva: information.
Patti Silva: And you know it it, like I said, it would be kept, you know, just
Patti Silva: among the Council.
Patti Silva: So if you guys are OK with that, I can put something together and
Patti Silva: just send it out to to you to fill in your info and and you
Patti Silva: know, once it's all completed, I can I can shoot it back out to
Patti Silva: everybody. So you'll have it for ref.
Patti Silva: And and you know, whatever you know purposes, it's great if
Patti Silva: we're, you know, doing like subcommittee planning and and,
Patti Silva: you know.
Patti Silva: You sent an e-mail, but you wanna give a call or something
Patti Silva: like that so.
Patti Silva: If you guys are all OK with that, I could go ahead and and
Patti Silva: finish that up and send it out and we'll we'll get it all
Patti Silva: filled in.
Patti Silva: Does that sound alright to everybody?
Patti Silva: Yeah, I'm seeing shaking heads.
Patti Silva: OK.
Patti Silva: All right. OK.
Patti Silva: So I'll I'll go ahead and do that.
Patti Silva: And then topics for future meetings.
Patti Silva: Well, next month is our our joint meeting. So that I think
Patti Silva: is pretty filled up and December is our annual meeting.
Patti Silva: Where we usually do our our nominating committee vote and
Patti Silva: that sort of thing. So.
Patti Silva: I'm not sure if we have time for a presentation.
Patti Silva: Kevin Bronson, do you have your hand up?
Bronson, Kevin: New Kevin Bronson, dds.
Bronson, Kevin: I just wanted to remind you, Patty, seeing that this is your
Bronson, Kevin: first time being chair that in the December meeting you also
Bronson, Kevin: pick the dates for 2025.
Patti Silva: Thank you.
Patti Silva: The calendar together for for the OK.
Patti Silva: Adrian, see your hand up.
aadriennebb@gmail.com: Thank you, Adrian Benjamin, councilmember. I just, I brought
aadriennebb@gmail.com: this up last year. Last month at the end.
aadriennebb@gmail.com: So I we used to go on field trips and it was really helpful
aadriennebb@gmail.com: and informative.
aadriennebb@gmail.com: One year we went.
aadriennebb@gmail.com: One month we went to Kevin Zinglars Mark program in
aadriennebb@gmail.com: Manchester and learned a lot about. We just toured his whole
aadriennebb@gmail.com: space and it was fabulous for people who aren't that familiar
aadriennebb@gmail.com: with group homes and day programs. It's it's a great way
aadriennebb@gmail.com: to see. It doesn't have to be.
aadriennebb@gmail.com: His again, but someone's.
aadriennebb@gmail.com: We went to.
aadriennebb@gmail.com: The oh, gosh, what's it called? This big center?
aadriennebb@gmail.com: Oh God, I'm Walgreens.
Scheff, Jordan A: Oh, the the Walgreens distribution plant in Windsor,
aadriennebb@gmail.com: Place the Walgreens where they have a commitment to hiring a
Scheff, Jordan A: CT.
aadriennebb@gmail.com: third of their people. Have a disability, which is pretty
aadriennebb@gmail.com: amazing.
aadriennebb@gmail.com: We also went to the hospital for Special Care's new autism
aadriennebb@gmail.com: program and did some tours.
aadriennebb@gmail.com: I think I know we can't do that every month and I'm not
aadriennebb@gmail.com: suggesting that, but it would be good to put our heads together
aadriennebb@gmail.com: and think about visiting, learning more, seeing more.
aadriennebb@gmail.com: We all sort of know our own kids situation.
aadriennebb@gmail.com: On our own setting situation, but to get a broader perspective
aadriennebb@gmail.com: for us, I think it would be great.
aadriennebb@gmail.com: That is all.
Patti Silva: Thank you, Adrian Petty Council chair.
Patti Silva: Pen, you have your hand raised.
Pam DonAroma: Pam Dynoroma, Council member, a few things.
Pam DonAroma: I don't know if everybody knows when resigned as Ark executive
Pam DonAroma: today.
aadriennebb@gmail.com: No.
Pam DonAroma: So that was a a big disappointment.
Pam DonAroma: He has some health issues, so he submitted his resignation.
aadriennebb@gmail.com: Oh no, I'm sorry.
Pam DonAroma: So I know that there's going to be a search committee also.
Pam DonAroma: I don't know if we wanted to consider, you know, doing a live
Pam DonAroma: meeting in December.
Pam DonAroma: You know, considering it's the holidays, that was something I
Pam DonAroma: know we had talked about before.
Pam DonAroma: Just something to consider.
aadriennebb@gmail.com: And bring food and cookies like we used to.
Pam DonAroma: We ha we have the most amazing ovens that were purchased by DDS
aadriennebb@gmail.com: Oh.
Pam DonAroma: that.
Pam DonAroma: Commissioner Heschel has yet to see, and now we're going to have
Scheff, Jordan A: It's true.
Pam DonAroma: them in two locations as soon as we open up our new building in
Pam DonAroma: Harford, there will also be a new commercial kitchen operating
Pam DonAroma: out of Hartford.
Scheff, Jordan A: And.
Pam DonAroma: We're producing 500 meals over 500 meals a week. With those
Pam DonAroma: with those ovens.
aadriennebb@gmail.com: What?
Patti Silva: You're learning a sin, right, Pam?
aadriennebb@gmail.com: That sounds amazing on many, many levels.
Patti Silva: Yeah.
Pam DonAroma: They are pretty. They are amazing.
aadriennebb@gmail.com: Wow.
Patti Silva: No, thank you.
Patti Silva: Pam Jordan, do you have your hand raised as well?
Scheff, Jordan A: Yeah, Jordan, chef, Commissioner, DDS to Adrian's
Scheff, Jordan A: point, I don't remember if we've been to any of the supportive
Scheff, Jordan A: housing settings. We've stood up like the ones we're up at.
Scheff, Jordan A: Favar.
Scheff, Jordan A: I know there's some going in Hartford, but we now have them
Scheff, Jordan A: around the state.
Scheff, Jordan A: I think we have six or seven operational and I I would love
Scheff, Jordan A: for you to see what I've been talking about in terms of.
Scheff, Jordan A: The community built around.
Scheff, Jordan A: An apartment building that is only 25% people with
Scheff, Jordan A: disabilities.
Scheff, Jordan A: Disabilities at a Max and just the sense of community and the
Scheff, Jordan A: beauty of the buildings and all that.
Scheff, Jordan A: So I would suggest winter time's harder, but I I would still
Scheff, Jordan A: suggest we try and get out and see if you want a tour
Scheff, Jordan A: someplace. And I don't want to miss.
Scheff, Jordan A: I do need to see the ovens I've been talking about seeing the
Scheff, Jordan A: ovens since Peter's retirement and I need to go see the oven
Scheff, Jordan A: so, but I don't need you all to go with me.
Scheff, Jordan A: I can go visit Pam all on my own, like a big boy.
Scheff, Jordan A: But if you guys want the cookies then you have to come with me.
aadriennebb@gmail.com: Let's go.
Patti Silva: Patti Silva, Council chair, PM, would that offer be open for the
Patti Silva: December meeting?
Pam DonAroma: Sure.
aadriennebb@gmail.com: When? What?
Patti Silva: But when you.
aadriennebb@gmail.com: What's the date?
Pam DonAroma: Came down Aroma Council member.
Pam DonAroma: My dog is barking.
Patti Silva: December 19th. That's when the that's when the December meeting
Patti Silva: is.
Patti Silva: What do you guys think of that?
Pam DonAroma: Up.
aadriennebb@gmail.com: Be fun.
Patti Silva: I see Lisa has her hand up.
Patti Silva: Peace. Are you there?
Pam DonAroma: Hello.
Lisa Weisinger: I'm here.
Lisa Weisinger: Can you guys hear me?
Lisa Weisinger: I have two questions.
Lisa Weisinger: One is, I think, Adrian, you were just talking about the
Lisa Weisinger: hospital for special care.
Lisa Weisinger: There's there's a new or something autism program.
Lisa Weisinger: Do you guys know who's in charge of that or how I can get and get
Lisa Weisinger: some information about it?
Diana Mennone: Run.
Lisa Weisinger: Pam.
Pam DonAroma: Come down around a council member, Lynn Riccio is retiring
Pam DonAroma: as well.
Pam DonAroma: She would be the person to contact.
Pam DonAroma: She's currently the CEO, but.
Pam DonAroma: I don't know how long she has until her retirement, but she
Pam DonAroma: would be the person to contact for now.
Lisa Weisinger: Can you send me her information?
Pam DonAroma: Sure.
Lisa Weisinger: OK, great.
Lisa Weisinger: And then along another route is I don't know who to to ask this,
Lisa Weisinger: but maybe Jordan, we came across a bill a long time ago.
Lisa Weisinger: House Bill 23, blah blah blah. That was talking about how maybe
Lisa Weisinger: Pam can sort of bring it up a little bit better for us in
Lisa Weisinger: terms of reimbursing the employers for those individuals,
Lisa Weisinger: those companies that had more than 10%.
Lisa Weisinger: Of their workforce.
Lisa Weisinger: With people with IDD and it was quite a big reimbursement for
Lisa Weisinger: the for the employers. But we found out that there's a
Lisa Weisinger: loophole that the employers not only have to have more than 10%
Lisa Weisinger: of their workforce of people with IDD, but they also had to
Lisa Weisinger: have more.
Lisa Weisinger: Than 50% of their product sold out of state now.
Lisa Weisinger: We don't know where that came from.
Lisa Weisinger: We've talked to a bunch of legislators and they don't know
Lisa Weisinger: anything about it.
Lisa Weisinger: Do you know anything about it?
Scheff, Jordan A: If you want to go first.
Patti Silva: Yep, Yep.
Pam DonAroma: Well, I contacted Pam, Don Aroma Council member.
Pam DonAroma: I contacted economic development because Damian and I were all
Pam DonAroma: excited, thinking, you know, we can get reimbursed and stop
Pam DonAroma: being, you know, in the hole.
Pam DonAroma: And we were informed that even though, you know, we were hiring
Pam DonAroma: at competitive wages, individuals with IDD, we did not
Pam DonAroma: qualify because 50% of our of our sales.
Pam DonAroma: Did not come from out of state.
Pam DonAroma: I tried to sell him on the fact that we have Internet sales, but
aadriennebb@gmail.com: What?
Pam DonAroma: you had to show that 50% and Damian, if if I'm forgetting
Pam DonAroma: something, you know, remind me, but it was.
Pam DonAroma: It was pretty frustrating.
Pam DonAroma: In in the legislation really doesn't make a whole lot of
Pam DonAroma: sense to us.
Scheff, Jordan A: I if I can just add Jordan, Chef, Commissioner, I circled
Scheff, Jordan A: around with Katie on this.
Scheff, Jordan A: KD rock Burns make chief of staff COO and I think there was
Scheff, Jordan A: good intentions in that bill and somewhere along the line in
Scheff, Jordan A: terms of it going from the starting point to the finish
Scheff, Jordan A: line, it got languaged in such a way that I don't know that
aadriennebb@gmail.com: Replay.
Scheff, Jordan A: anybody's.
Scheff, Jordan A: Really benefiting in any way I can think of a few places in
Scheff, Jordan A: Connecticut that might be candidates, you know, and I
Scheff, Jordan A: won't.
Scheff, Jordan A: I won't call them out.
Scheff, Jordan A: But there are there are, you know, places here that ship a
Scheff, Jordan A: lot out of state, but to then also have 10% of your workforce
Scheff, Jordan A: meet that criteria and do that. I'm not aware of anybody
Scheff, Jordan A: participating in the program. So finding out who sponsored the
Scheff, Jordan A: bill and their.
Scheff, Jordan A: Intent and maybe trying to see if we can get that language
Scheff, Jordan A: change.
Scheff, Jordan A: I'm sorry if you want to consider seeing that language
Scheff, Jordan A: change so that it actually has benefit 'cause. I think it's
Scheff, Jordan A: also.
Scheff, Jordan A: There, there's some language in there about whether you're for
Scheff, Jordan A: profit or not-for-profit.
Scheff, Jordan A: Which impacts as well, so.
Scheff, Jordan A: We, we, we we need to see more. But I do think that while it was
Scheff, Jordan A: well intended, the outcomes have been disappointing, not just for
Scheff, Jordan A: upam, but for anybody who's really looked at it.
Lisa Weisinger: Is there something that we can do, Jordan to help with that?
Lisa Weisinger: Because we seem to be putting a lot of pressure on or some
Lisa Weisinger: pressure on the the legislators, and no one seems to know what's
Lisa Weisinger: going on or where that bill came from and who added that at the
Lisa Weisinger: very last minute.
Lisa Weisinger: But it really defeats the purpose of of the reason why it
Lisa Weisinger: was set up in the 1st place. There isn't any.
Lisa Weisinger: There isn't any company that can meet all the criteria that
Lisa Weisinger: they've asked for and we've we're leaving money on the table
Lisa Weisinger: where people like Pam and Park and favour.
Lisa Weisinger: Employing greater than 10% of those individuals with IDD can't
Lisa Weisinger: get this money to stay in business and keep our family
Lisa Weisinger: members in in a job.
Lisa Weisinger: So I'm looking for any kind of help that I can do to support
Lisa Weisinger: that that change.
Scheff, Jordan A: Gordon, chef, DDS, Commissioner, Kevin, can you and Jill take a
Scheff, Jordan A: look and see if you can trace to the roots and point people in
Scheff, Jordan A: the right way?
Bronson, Kevin: Yeah, Kevin Bronson, dds.
Jacovino, Shannon: Thank you.
Bronson, Kevin: Pam, do you happen to have the bill number off the top of your
Bronson, Kevin: head? Or if you don't, I can look it up.
Pam DonAroma: No.
Bronson, Kevin: OK, alright.
Bronson, Kevin: Yes, I can circle back.
Lisa Weisinger: Kevin, I'll Kevin. I'll send it to you.
Bronson, Kevin: Beautiful. Thank you.
Lisa Weisinger: Yep, no problem.
Lisa Weisinger: Thank you for looking it up.
Patti Silva: OK.
Patti Silva: Patty Silva, Council chair.
Patti Silva: Are you all set, Lisa?
Lisa Weisinger: Thank you.
Patti Silva: Yep. We have Diana with her hand up.
Diana Mennone: Thanks Diana. Manon, Council member.
Diana Mennone: I just wanted to say about the December meeting, if COVID isn't
Diana Mennone: really bad, I think it's a great idea to get together. But I know
Diana Mennone: from my my own experience that our holidays have been ruined
Diana Mennone: pretty much every year.
Diana Mennone: So I tend to not go out too much before the holidays.
Diana Mennone: Thanks.
Patti Silva: Understood. Yes. Patty Silva, Council chair PM.
Patti Silva: Do you have the capability to host a teens meeting at your
Patti Silva: location? For those who you know wouldn't be able to attend in
Patti Silva: person?
Pam DonAroma: Damien Damien's our tech guy.
Damion Williams: We have done like virtual like walkthroughs and things just so
Damion Williams: you guys can get some some you know measure of understanding of
Damion Williams: you know the equipment we have and what it's capable of.
Damion Williams: So yeah, we have done it.
Damion Williams: It's obviously it's not as ideal as being in person, but yeah, I
Damion Williams: mean just for us to introduce you to some of the stuff we have
Damion Williams: and how it works and how it really supports the individuals,
Damion Williams: I think we could do that.
Pam DonAroma: Pemdon aroma, Damien. I think they're referring to can we for
Pam DonAroma: those people that wanted to participate, you know,
Pam DonAroma: virtually.
Pam DonAroma: In our in our new building, I believe that you can set
Pam DonAroma: something up where they can participate, correct?
Damion Williams: Certainly we.
Damion Williams: Yeah, we've done that.
Patti Silva: So we could host a Council meeting.
Patti Silva: There and people who wanted to call in remotely could do that
Patti Silva: just like we're doing now.
Damion Williams: Yeah, that that would work.
Damion Williams: That, that's that's.
Patti Silva: OK.
Patti Silva: OK. 'cause, we definitely wanna have that option for everybody.
Patti Silva: All right.
Patti Silva: Do you guys want to take a vote or make a motion that we hold
Patti Silva: our December meeting at?
Patti Silva: Pam's.
Patti Silva: In Pam's ovens.
Patti Silva: Anybody want to make a motion?
Christine (Guest): I'll move that we try to meet in person.
Christine (Guest): At this time, at futures at the designated meeting time.
Patti Silva: OK. Is there a second?
Deidre Toole: I'll 2nd.
Patti Silva: I think Michael had his hand up first. Thank you, Deirdre.
Patti Silva: All right.
Patti Silva: So all in favor of holding the December meeting at Futures, say
Patti Silva: I I.
Michael Beloff: OK.
Patti Silva: Any opposed?
Patti Silva: There being none, looks like we will have our December meeting
Patti Silva: at futures.
Patti Silva: And Christine, did you have a question?
Christine (Guest): Yes. I was just flipping my calendar to put it on my
Christine (Guest): calendar and I think our meeting was moved forward to the 12th.
Christine (Guest): Because of the holidays.
Patti Silva: Thank you.
Christine (Guest): Those the 12th, not the 19th.
Christine (Guest): Shannon says yes to OK.
Patti Silva: Yeah, that's what I yeah, yeah.
Christine (Guest): So it's it's supposed to 12th, not the 19th Pam.
Patti Silva: Right.
Patti Silva: Yes, OK.
Patti Silva: So it would be December 12th at 5:00 PM at futures.
Patti Silva: OK.
Patti Silva: So do.
Patti Silva: Wes, would you need to make the change for the meeting on the
Patti Silva: website?
Tsegai, Wesaneit: For the location, I believe so.
Patti Silva: OK.
Tsegai, Wesaneit: I will confirm how that helps to work.
Patti Silva: Yeah. Kevin, is there any anything official we need to do
Patti Silva: other than that?
Patti Silva: Noticing or.
Bronson, Kevin: I I'll check, but it might have to be considered a special
Bronson, Kevin: meeting and you canceling the the meeting on the 19th, if that
Bronson, Kevin: makes sense.
Christine (Guest): We already went through that with the 19th.
Bronson, Kevin: Just.
Christine (Guest): It's already been scheduled as the 12th.
Bronson, Kevin: Oh, then, yeah, then no.
Bronson, Kevin: Then just the change location on the calendar. Yep.
Christine (Guest): It's just the location change.
Patti Silva: OK.
Patti Silva: Very good, alright.
Patti Silva: Looking forward to it, Pam. Thank you.
Patti Silva: Alright, so I I think that's it for tonight.
Patti Silva: Did anybody have anything else?
Patti Silva: Oh, Jordan is pm. Is your hand a legacy?
Deidre Toole: Thank you.
Patti Silva: OK.
Patti Silva: So then Jordan.
Patti Silva: You're you're.
Scheff, Jordan A: Damien beat me to the punch in the chat.
Scheff, Jordan A: Jordan chef, Commissioner, DDS, as we've been recording the
Scheff, Jordan A: meetings for the purposes of chronicling them.
Scheff, Jordan A: Damien West.
Scheff, Jordan A: Kevin and I can maybe meet offline to make sure that we can
Scheff, Jordan A: capture what we need to for an off site meeting without having
Scheff, Jordan A: to go back to formal minutes and especially with the bylaws
Scheff, Jordan A: change and all that, we also need.
Scheff, Jordan A: Yeah. So we'll do that offline.
Scheff, Jordan A: I'm sure we can figure it out, but I just wanted to make
Scheff, Jordan A: mention of that.
Patti Silva: Great. Thank you.
Patti Silva: And Deirdre, you have your end up.
Deidre Toole: Yes, I'm. I'm down here in Mystic, so I I don't know where
Deidre Toole: the oven's and futures are.
Damion Williams: 1158 Broad St.
Damion Williams: In Middletown.
Deidre Toole: Middletown, OK.
Deidre Toole: Great. Thank you.
Patti Silva: All right.
Patti Silva: Anybody else?
Patti Silva: I think we have some legacy hands up, OK.
Patti Silva: Great. If that's it, then does somebody want to make a motion
Patti Silva: to adjourn?
Pam DonAroma: Motion to adjourn. I second the motion.
Patti Silva: OK, Adriana and then Pam.
Patti Silva: OK, all in favor.
Patti Silva: Hi. OK. We are adjourned.
Deidre Toole: Hi.
Damion Williams: Right.
Patti Silva: It is 633.
Patti Silva: Thank you everybody.
Patti Silva: We had a pretty productive meeting and a great
Patti Silva: presentation. So we will see you all next month on November 21st
Patti Silva: at 5:00 PM at the joint meeting. All right. Thanks everybody.
Patti Silva: Have a great night.
Deidre Toole: Thank you.
Patti Silva: Bye bye.
Adrianna Ramirez: Have a great weekend.